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CION Cancer Clinics
Groin node surgery in penile cancer: why it is done and what to expect | CION Cancer Clinics
Penile cancer usually spreads first to the lymph nodes in the groin. Groin node surgery, called inguinal lymph node dissection, removes some or all of those glands to check for cancer or to take it out. Not every man needs it. This page explains how your team decides, the options from close watching to a full dissection, what recovery is like and when to call. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Why do the groin glands matter in penile cancer?
- What are the different ways the groin glands are dealt with?
- What happens from the operation to getting back on your feet?
- What do the words about the glands mean?
- What do families often get wrong about groin surgery?
- What should you ask, and what can this page not tell you?
- Common questions about groin node surgery in penile cancer
The short answer
Why do the groin glands matter in penile cancer?
Penile cancer usually spreads first to the lymph nodes in the groin, the small glands at the top of each thigh. Groin node surgery removes some or all of those glands, either to check whether cancer has reached them or to take out cancer that already has. On a report you may see it called inguinal lymph node dissection.
Why it is a separate decision from the penis operation
Removing the cancer from the penis does not tell your team whether it has already travelled to the groin. Small deposits in the glands often cannot be felt or seen on a scan. So the team looks at the biopsy report, how deep the cancer has grown and how the cells look, and weighs whether the glands need checking. Sometimes the groin operation is done at the same time as the penis operation. Sometimes it comes a few weeks later.
Who may not need it
Men with a small, shallow, low-grade cancer and normal-feeling groins may be offered careful watching instead, with regular examinations and scans. That only works if you come to every follow-up visit. Men who are too unwell for surgery may be offered other treatments. Your team will explain why they are recommending what they recommend.
This page explains the choices. It cannot tell you which one is right for you. That decision belongs to your treating team.The options
What are the different ways the groin glands are dealt with?
They range from watching closely to a large operation. Which one is suggested depends on the risk that cancer has spread.
Close watching
No operation on the groin for now. The groins are examined at every visit, often with an ultrasound scan. Suits lower-risk cancers where the glands feel normal.
Sentinel node biopsy
A tracer is injected near the cancer to find the first gland it drains to. Only that gland, or a few, are removed and tested. If they are clear, the rest are usually left alone.
Needs a nuclear medicine department and a team experienced in the technique. Ask whether it is available.Modified groin dissection
A smaller operation that removes the glands most likely to be affected while keeping some of the surrounding tissue. It is often used when the glands feel normal but the risk of spread is higher.
Radical groin dissection
Removes all the glands in the groin. Used when cancer has been confirmed in the glands, usually by a needle test first.
Sometimes followed by
- Removal of glands inside the pelvis
- Chemotherapy or radiotherapy
Not sure whether this applies to you?
Ask an oncologistThe pathway
What happens from the operation to getting back on your feet?
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The operation
Done under general or spinal anaesthesia. The cut runs along or just below the crease of the groin. If both sides are needed, both may be done in the same operation.
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Drains
A thin tube is left in each groin to carry away the fluid that collects after glands are removed. It often stays in for some time, sometimes after you go home, until the fluid slows down.
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The first days
You will be helped to walk early to lower the risk of clots. You may be given injections to thin the blood and stockings for your legs. Keep the leg raised when resting.
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Wound healing at home
Groin wounds heal more slowly than most, because the skin is thin and the area moves and sweats. Keep it clean and dry. Wound problems are common and are usually managed with dressings.
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The pathology result
The glands are examined under a microscope. The result tells your team whether more treatment is needed and shapes your follow-up plan.
!
When not to wait
Call your team or go to the nearest emergency department the same day if the groin wound turns red and hot with the redness spreading, leaks pus or smells bad, or if you have a fever or shivering. Go at once if one calf becomes suddenly swollen and painful, or you become breathless or have chest pain. That can be a clot. Do not wait for the next appointment, and do not start leftover antibiotics at home.
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On your report
What do the words about the glands mean?
- Inguinal lymph nodes
- The glands in the groin. They filter fluid from the penis, the lower belly and the legs.
- Palpable nodes
- Glands the doctor can feel when examining you. Not every enlarged gland is cancer; some are swollen by infection.
- FNAC
- A thin needle test that takes cells from a gland to check for cancer before any larger operation.
- Extranodal extension
- Cancer that has broken through the outer wall of a gland. It usually means more treatment is advised after surgery.
- Seroma
- A pocket of clear fluid that collects under the wound after the drain comes out. It may need draining with a needle.
- Lymphoedema
- Long-term swelling of the leg or scrotum, because fluid no longer drains well after glands are removed.
Commonly believed
What do families often get wrong about groin surgery?
"The swelling in the groin is just from the infection on the penis."
Sometimes it is, and a course of antibiotics may be tried first. But a gland that stays enlarged needs a needle test. Assuming it is infection for months is one of the ways cancer in the glands is found late.
"If the penis operation went well, the groin can be left."
The two are separate. A clear result on the penis says nothing about whether cells have already reached the glands. Your team decides about the groin based on the features of the cancer, not only on how the first operation went.
"Watching instead of operating means the doctor is not taking it seriously."
For lower-risk cancers, close watching is a standard, deliberate choice that avoids an operation with real side effects. It depends on you attending every check.
"Leg swelling afterwards means the cancer is back."
Swelling is a common effect of removing the glands and usually has nothing to do with the cancer. New, hard lumps are different. Report those.
Being straight with you
What should you ask, and what can this page not tell you?
Groin node surgery carries more side effects than many men expect, often more than the operation on the penis. Wound breakdown, fluid collections and leg swelling are all well recognised. How likely they are depends on the type of operation, your weight, diabetes, smoking and whether you have had radiotherapy. Your surgeon should explain them before you agree.
Living with leg swelling
If swelling develops, it is usually managed rather than removed. Compression stockings, gentle exercise, skin care and raising the leg all help. Look after small cuts on the leg, because infection spreads more easily in a swollen limb. A physiotherapist can show you what to do.
Questions worth asking
Why do you recommend this option for my groins? Is sentinel node biopsy possible here? Will you operate on one side or both? How long will the drains stay in? What happens if the glands show cancer? Some centres use keyhole techniques for the groin, so ask whether that applies to you.
This page cannot tell you whether cancer has reached your glands. Only the tests your team arranges can answer that.Questions we are asked
Common questions about groin node surgery in penile cancer
Does everyone with penile cancer need groin surgery?
No. Men with small, shallow, low-grade cancers and normal groins are often watched closely instead. Men with a higher risk of spread usually have the glands checked, by sentinel node biopsy or a dissection. Men with glands that are clearly involved usually need a larger operation. Your report decides which group you are in.
Will both groins be operated on?
Often, yes. The penis drains to glands on both sides, so cancer can reach either groin even if the lump on the penis is on one side. Your surgeon will explain whether one or both sides are planned, and why, based on your examination and scans.
How long will I stay in hospital?
It depends on the operation. A sentinel node biopsy may need only a short stay. A full dissection usually means several days, and you may go home with the drains still in. Your team will tell you what to expect for the operation they plan.
Will my leg be swollen for life?
Not always. Some men have little or no swelling, while others develop swelling that lasts. It is more likely after a full dissection and after radiotherapy to the groin. Stockings, exercise and skin care help control it. Ask to see a physiotherapist early if it starts.
My groin wound has opened. Is this serious?
Wound opening is one of the most common problems after this operation, and it usually heals with dressings over time. Call your team so they can check it. It becomes urgent if there is spreading redness, pus, a bad smell, fever or bleeding. Then go the same day.
Can I walk normally afterwards?
You are encouraged to walk from the first days. Bending at the hip may pull on the wound for a while. Avoid heavy lifting and long periods sitting with the legs down until your surgeon says otherwise. Most men return to normal walking once the wound has healed.
What if cancer is found in the glands?
Your team will look at how many glands were affected and whether cancer broke through their outer wall. They may recommend removing glands inside the pelvis, or chemotherapy or radiotherapy. This page cannot say what your outlook is. Ask your team to explain what the result means for you.
Is keyhole groin surgery better?
Keyhole techniques aim to reduce wound problems, and some centres use them. They are not available everywhere and do not suit every man, especially if the glands are large or stuck. Ask your surgeon whether it applies to you, and how much experience the team has with it.
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Sources
- Cancer Research UK — Penile cancer: treatment
- National Cancer Institute — Penile Cancer Treatment (PDQ) - Patient Version
- Macmillan Cancer Support — Penile cancer
- American Cancer Society — Penile cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Penile Cancer Surgery: What Your Options AreWhere the groin decision fits in the whole planDrains, Tubes, Lines and CathetersLooking after the groin drains at homeComplications and Red FlagsWound problems and clots, and when to go inThe Pathology Report After SurgeryReading what the gland result saysFollow-Up After Penile Cancer SurgeryHow the groins are checked after treatment
Talk to us
Been told your groin glands need checking?
Send us the biopsy report and any scans, or call the helpline. A surgical oncologist will explain what is planned for the groins and why. One helpline serves every CION centre.